Quantifying infective endocarditis risk in patients with predisposing cardiac conditions

Aims: There are scant comparative data quantifying the risk of infective endocarditis (IE) and associated mortality in individuals with predisposing cardiac conditions. Methods and results: English hospital admissions for conditions associated with increased IE risk were followed for 5 years to quantify subsequent IE admissions. The 5-year risk of IE or dying during an IE admission was calculated for each condition and compared with the entire English population as a control. Infective endocarditis incidence in the English population was 36.2/million/year. In comparison, patients with a previous history of IE had the highest risk of recurrence or dying during an IE admission [odds ratio (OR) 266 and 215, respectively]. These risks were also high in patients with prosthetic valves (OR 70 and 62) and previous valve repair (OR 77 and 60). Patients with congenital valve anomalies (currently considered 'moderate risk') had similar levels of risk (OR 66 and 57) and risks in other 'moderate-risk' conditions were not much lower. Congenital heart conditions (CHCs) repaired with prosthetic material (currently considered 'high risk' for 6 months following surgery) had lower risk than all 'moderate-risk' conditions-even in the first 6 months. Infective endocarditis risk was also significant in patients with cardiovascular implantable electronic devices. Conclusion: These data confirm the high IE risk of patients with a history of previous IE, valve replacement, or repair. However, IE risk in some 'moderate-risk' patients was similar to that of several 'high-risk' conditions and higher than repaired CHC. Guidelines for the risk stratification of conditions predisposing to IE may require re-evaluation

Patterns of eye-movements when Male and Female observers judge female attractiveness, body fat and waist-to-hip ratio

Behavioural studies of the perceptual cues for female physical attractiveness have suggested two potentially important features; body fat distribution (the waist-to-hip ratio or WHR) and overall body fat (often estimated by the body mass index or BMI). However none of these studies tell us directly which regions of the stimulus images inform observers’ judgments. Therefore, we recorded the eye-movements of 3 groups of 10 male observers and 3 groups of 10 female observers, when they rated a set of 46 photographs of female bodies. The first sets of observers rated the images for attractiveness, the second sets rated for body fat and the third sets for WHR. If either WHR and/or body fat are used to judge attractiveness, then observers rating attractiveness should look at those areas of the body which allow assessment of these features, and they should look in the same areas when they are directly asked to estimate WHR and body fat. So we are able to compare the fixation patterns for the explicit judgments with those for attractiveness judgments, and infer which features were used for attractiveness. Prior to group analysis of the eye-movement data, the locations of individual eye fixations were transformed into a common reference space to permit comparisons of fixation density at high resolution across all stimuli. This manipulation allowed us to use spatial statistical analysis techniques to show: 1) Observers’ fixations for attractiveness and body fat clustered in the central and upper abdomen and chest, but not the pelvic or hip areas, consistent with the finding that WHR had little influence over attractiveness judgments. 2) The pattern of fixations for attractiveness ratings was very similar to the fixation patterns for body fat judgments. 3) The fixations for WHR ratings were significantly different from those for attractiveness and body fat

Phylogenomics and the rise of the angiosperms

Angiosperms are the cornerstone of most terrestrial ecosystems and human livelihoods1,2. A robust understanding of angiosperm evolution is required to explain their rise to ecological dominance. So far, the angiosperm tree of life has been determined primarily by means of analyses of the plastid genome3,4. Many studies have drawn on this foundational work, such as classification and first insights into angiosperm diversification since their Mesozoic origins5,6,7. However, the limited and biased sampling of both taxa and genomes undermines confidence in the tree and its implications. Here, we build the tree of life for almost 8,000 (about 60%) angiosperm genera using a standardized set of 353 nuclear genes8. This 15-fold increase in genus-level sampling relative to comparable nuclear studies9 provides a critical test of earlier results and brings notable change to key groups, especially in rosids, while substantiating many previously predicted relationships. Scaling this tree to time using 200 fossils, we discovered that early angiosperm evolution was characterized by high gene tree conflict and explosive diversification, giving rise to more than 80% of extant angiosperm orders. Steady diversification ensued through the remaining Mesozoic Era until rates resurged in the Cenozoic Era, concurrent with decreasing global temperatures and tightly linked with gene tree conflict. Taken together, our extensive sampling combined with advanced phylogenomic methods shows the deep history and full complexity in the evolution of a megadiverse clade

Antibiotic prophylaxis of endocarditis: a NICE mess

NICE guidance written in 2008, and revised in 2015, no longer recommends antibiotic prophylaxis in patients at high-risk of infective endocarditis who are undergoing high-risk dental procedures. This guidance is different from every international guideline, including a 2015 European Society of Cardiology revision. The European guideline committee considered, but rejected, the NICE view. How has this important difference in advice arisen and what are its implications

Towards a History of Mass Violence in the Etat Indépendant du Congo, 1885-1908

The present article provides an up-to-date scholarly introduction to mass violence in the Etat Indépendant du Congo (Congo Free State, EIC). Its aims are twofold: to offer a point of access to the extensive literature and historical debates on the subject, and to make the case for exchanging the currently prevalent top-down narrative, with its excessive focus on King Leopold's character and motives, for one which considers the EIC's culture of violence as a multicausal, broadly based and deeply engrained social phenomenon. The argument is divided into five sections. Following a general outline of the EIC's violent system of administration, I discuss its social and demographic impact (and the controversy which surrounds it) to bring out the need for more regionally focused and context sensitive studies. The dispute surrounding demographics demonstrates that what is fundamentally at stake is the place the EIC's extreme violence should occupy in the history of European ‘modernity’. Since approaches which hinge on Leopoldian exceptionalism are particularly unhelpful in clarifying this issue, I pause to reflect on how such approaches came to dominate the distinct historiographical traditions which emerged in Belgium and abroad before moving on to a more detailed exploration of a selection of causes underlying the EIC's violent nature. While state actors remain in the limelight, I shift the focus from the state as a singular, normative agent, towards the existence of an extremely violent society in which various individuals and social groups within and outside of the state apparatus committed violent acts for multiple reasons. As this argument is pitched at a high level of abstraction, I conclude with a discussion of available source material with which it can be further refined and updated

Analysis of MONARC and ACTIVATE Airborne Aerosol Data for Aerosol-Cloud Interaction Investigations: Efficacy of Stairstepping Flight Legs for Airborne In Situ Sampling

A challenging aspect of conducting airborne in situ observations of the atmosphere is how to optimize flight plans for specific objectives and constraints associated with weather and flight restrictions. For aerosol-cloud interaction research, two recent campaigns utilized a “stairstepping” approach whereby an aircraft conducts level legs at various altitudes while moving forward with each subsequent leg: the 2019 MONterey Aerosol Research Campaign (MONARC) over the northeast Pacific and the 2020–2022 Aerosol Cloud meTeorology Interactions oVer the western ATlantic Experiment (ACTIVATE) over the northwest Atlantic. We examine the homogeneity of several atmospheric variables both vertically and horizontally in the marine boundary layer with a focus on the sub-cloud environment. In well-mixed boundary layers, there was generally good horizontal and vertical homogeneity in potential temperature, winds, water vapor mixing ratio, various trace gases, and many aerosol variables. Selected aerosol variables exhibited the most variability owing to sensitivity to humidity and near-cloud conditions (supermicrometer aerosol concentrations), coastal pollution gradients (e.g., organic aerosol mass), and small spatial scale phenomena such as new particle formation (aerosol number concentration for particles with diameter >3 nm). Illustrative cases are described when stairstepping can pose issues requiring extra caution for data analysis: (i) poor vertical mixing and layers decoupled from those below; (ii) multiple cloud layers; (iii) fluctuating cloud base/top and boundary layer top heights; and (iv) horizontal variability across specific features leading to sharp gradients such as right near coastlines and over the Gulf Stream with strong sea surface temperature changes. Results from this study provide a guide both for future studies aiming to examine these mission datasets and for designing new airborne campaigns. © 2022 by the authors.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]